title: Step by step: a proof of concept study of C-Mill gait adaptability training in the chronic phase after stroke.
abstract: OBJECTIVE
  To evaluate the concept of C-Mill gait adaptability training.
  
  
  METHODS
  Pre- and post-intervention assessments.
  
  
  METHODS
  Sixteen community-dwelling persons in the chronic phase after stroke (mean age 54.8 years).
  
  
  METHODS
  Participants received 10 sessions (1 h per session, for 5-6 weeks) of gait adaptability training on an instrumented treadmill augmented with visual targets and obstacles (C-Mill). Pre- and post-intervention assessments included: (i) clinical assessments of balance and gait: 10-m walking test, Timed Up-and-Go test, Berg Balance Scale, obstacle sub-task of the Emory Functional Ambulation Profile, and the Trunk Impairment Scale; (ii) physical activity level, assessed with a pedometer; (iii) success rate of accurate step adjustments towards a displacing target, assessed with an instrumented Target-Stepping Task; (iv) participant's experience with the training.
  
  
  RESULTS
  All clinical assessments improved significantly after training (all p < 0.05), except for the Trunk Impairment Scale (p = 0.584). Physical activity increased by 19.6% (p < 0.05). Improvements in Target-Stepping Task success rates depended on the specific testing condition (time × body support × step direction, χ2(1) = 3.884, p < 0.05). All participants appreciated the training.
  
  
  CONCLUSIONS
  The concept of C-Mill gait adaptability training in the chronic phase after stroke is promising and warrants future research involving a randomized controlled trial.
authors.affiliation: Department of Rehabilitation, Radboud University Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, The Netherlands.
authors.forename: Anita
authors.initials: A
authors.lastname: Heeren
authors.forename: Mariëlle
authors.initials: M
authors.lastname: van Ooijen
authors.forename: Alexander C H
authors.initials: AC
authors.lastname: Geurts
authors.forename: Brian L
authors.initials: BL
authors.lastname: Day
authors.forename: Thomas W J
authors.initials: TW
authors.lastname: Janssen
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Beek
authors.forename: Melvyn
authors.initials: M
authors.lastname: Roerdink
authors.forename: Vivian
authors.initials: V
authors.lastname: Weerdesteyn
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004185:Disability Evaluation; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology